Digital Mental Health Interventions for Depression, Anxiety, and Enhancement of Psychological Well-Being Among College Students: Systematic Review

Lattie, Emily G.; Adkins, Elizabeth C; Winquist, Nathan; Stiles‐Shields, Colleen; Wafford, Q. Eileen; Graham, Andrea K.

doi:10.2196/12869

Cited by 537 publications

(411 citation statements)

References 149 publications

(624 reference statements)

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“…A meta-analysis of 17 trials of 1,480 participants showed that computerized and web-based intervention were effective at reducing depression and anxiety compared with inactive control ( 4 ). A systematic review of 89 studies demonstrated that nearly 81% of digital mental health programs are effective or partially effective at reducing a variety of symptoms of common mental disorders and improving well-being ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

The Cultural Adaptation of Step-by-Step: An Intervention to Address Depression Among Chinese Young Adults

Sit¹,

Ling

Lam

et al. 2020

Front. Psychiatry

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Background Digital mental health interventions leverage digital communication technology to address the mental health needs of populations. Culturally adapting interventions can lead to a successful, scalable mental health intervention implementation, and cultural adaptation of digital mental health interventions is a critical component to implementing interventions at scale within contexts where mental health services are not well supported. Objective The study aims to describe the cultural adaptation of a digital mental health intervention Step-by-Step in order to address depression among Chinese young adults. Methods Cultural adaptation was carried out in four phases following Ecological Validity Model: (1) stage setting and expert consultation; (2) preliminary content adaptation; (3) iterative content adaptation with community members; (4) finalized adaptation with community feedback meetings. Cognitive interviewing was applied to probe for relevance, acceptability, comprehensibility, and completeness of illustrations and text. Six mental health experts and 34 Chinese young adults were recruited for key informant interviews and focus group discussions. Results We adapted the text and illustrations to fit the culture among Chinese young adults. Eight elements of the intervention were chosen as the targets of cultural adaptation (e.g., language, metaphors, content). Samples of major adaptations included: adding scenarios related to university life ( relevance ), changing leading characters from a physician to a peer and a cartoon ( acceptability ), incorporating two language versions (traditional Chinese and simplified Chinese) in the intervention ( comprehensibility ), and maintaining fundamental therapeutic components ( completeness ). Conclusion This study showed the utility of using Ecological Validity Model and a four-point procedure framework for cultural adaptation and achieved a culturally appropriate version of the Step-by-Step program for Chinese young adults.

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Section: Introductionmentioning

confidence: 99%

The Cultural Adaptation of Step-by-Step: An Intervention to Address Depression Among Chinese Young Adults

Sit¹,

Ling

Lam

et al. 2020

Front. Psychiatry

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“…The efficacy of digital mental health programs in college populations has been established. A systematic review found that the majority of digital mental health interventions for college students were effective in producing changes in psychological outcomes, such as depression and anxiety, yet few of the tested programs were publicly available and fewer were delivered via apps [ 3 ]. In addition, the vast majority of college students own smartphones, making apps a potentially accessible option to deliver services [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Examining an App-Based Mental Health Self-Care Program, IntelliCare for College Students: Single-Arm Pilot Study

Lattie¹,

Cohen²,

Winquist³

et al. 2020

JMIR Ment Health

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Background In recent years, there has been an increase in symptoms of depression, anxiety, and other mental illnesses in college student populations alongside a steady rise in the demand for counseling services. Digital mental health programs, such as those delivered through mobile apps, can add to the array of available services but must be tested for usability and acceptability before implementation. Objective This study aims to examine how students used IntelliCare for College Students over an 8-week period to examine the preliminary associations between app use and psychosocial targets and to gather user feedback about usability issues that need to be remedied before a larger implementation study. Methods IntelliCare for College Students is an app-based platform that provides symptom assessments with personalized feedback, information about campus resources, lessons on mental health and wellness topics, and access to the suite of interactive skill–focused IntelliCare apps. A total of 20 students were recruited to participate in an 8-week study. To test for a broad range of potential users, we recruited a mixed sample of students with elevated symptoms of depression or anxiety and students without elevated symptoms. Participants completed psychosocial questionnaires at baseline, week 4, and week 8. Participants also completed user feedback interviews at weeks 4 and 8 in which they provided feedback on their experience using the app and suggestions for changes they would like to be made to the app. Results Of the 20 students who downloaded the app, 19 completed the study, indicating a high rate of retention. Over the study period, participants completed an average of 5.85 (SD 2.1; range 1-8) symptom assessments. Significant improvements were observed in the Anxiety Literacy Questionnaire scores (Z=−2.006; P=.045) and in the frequency with which participants used both cognitive (Z=−2.091; P=.04) and behavioral (Z=−2.249; P=.03) coping skills. In the feedback interviews, we identified a high degree of usability with minor bugs in the app software, which were quickly fixed. Furthermore, in feedback interviews, we identified that users found the app to be convenient and appreciated the ability to use the program in short bursts of time. Conclusions The findings indicate that the IntelliCare for College Students program was perceived as largely usable and engaging. Although the program demonstrated usability and preliminary benefits to students, further testing is needed to determine its clinical utility among college students. Trial Registration ClinicalTrials.gov NCT04035577; https://clinicaltrials.gov/ct2/show/NCT04035577

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“…One promising approach is to provide self-help resources that students can access on their own, privately, whenever is convenient. Such self-guided resources have been found to be effective for college students (Lattie et al, 2019) and to be of interest to students, including those who otherwise might not seek services (Levin, Krafft & Levin, 2018). Research in this area has primarily focused on web and mobile programs, which theoretically is highly scalable due to minimal cost per end user once the platform is developed.…”

mentioning

confidence: 99%

Evaluating Acceptance and Commitment Therapy and Mindfulness-Based Stress Reduction Self-Help Books for College Student Mental Health

Levin

Davis

et al. 2020

Mindfulness

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Objectives: Self-help has the potential to improve access to mental health resources for college students. However, solutions are needed to improve sustainable delivery, cost-effectiveness, and to know which resources are most useful. Methods: A sample of 109 college students were randomly assigned to read either an Acceptance and Commitment Therapy (ACT) or Mindfulness-Based Stress Reduction (MBSR) self-help book through the University library website over 8 weeks with assessments at baseline, midtreatment (4-weeks), and posttreatment (8-weeks). Results: The majority of participants reported reading over half of their assigned book and high satisfaction ratings were given for both books. Both conditions demonstrated equivalent medium to large effect sizes for improvements over time on outcomes (psychological distress, positive mental health, academic distress) and processes of change (psychological inflexibility, mindfulness, cognitive fusion). However, the ACT condition produced improvements on obstruction with valued action more quickly than MBSR. Across conditions, baseline to midtreatment improvements in psychological inflexibility, valued action, cognitive fusion, and mindfulness all predicted baseline to posttreatment improvements in psychological distress. Improvements in psychological inflexibility more strongly predicted improvements in positive mental health in the MBSR condition. Conclusions: Overall, results suggest the potential benefits of both ACT and MBSR self-help books for improving student mental health and the potential promise of delivering these books through online university library systems.

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Digital Mental Health Interventions for Depression, Anxiety, and Enhancement of Psychological Well-Being Among College Students: Systematic Review

Cited by 537 publications

References 149 publications

The Cultural Adaptation of Step-by-Step: An Intervention to Address Depression Among Chinese Young Adults

The Cultural Adaptation of Step-by-Step: An Intervention to Address Depression Among Chinese Young Adults

Examining an App-Based Mental Health Self-Care Program, IntelliCare for College Students: Single-Arm Pilot Study

Evaluating Acceptance and Commitment Therapy and Mindfulness-Based Stress Reduction Self-Help Books for College Student Mental Health

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